Active NPI
Kenneth Ray Harris, MD
- Anatomic Pathology Physician
- Florence, SC
National Provider Identifier
1215628052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology Physician
- License
- 322721
- Practice address
- 153 Central Dr Apt a
Florence, SC 29501-4280 - Phone
- (626) 626-5181
- NPI assigned
- May 15, 2023
- Last updated
- May 15, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology Physician | 207ZP0101X | 322721 | NY | Primary |
Addresses
Primary practice location
153 Central Dr Apt a
Florence, SC 29501-4280
Mailing address
153 Central Dr Apt a
Florence, SC 29501-4280
Phone (626) 626-5181
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 322721 | NY | MD | Anatomic Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684108800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684108800000",
"number": "1215628052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "153 CENTRAL DR APT A",
"city": "FLORENCE",
"state": "SC",
"postal_code": "295014280",
"telephone_number": "626-626-5181"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "153 CENTRAL DR APT A",
"city": "FLORENCE",
"state": "SC",
"postal_code": "295014280",
"telephone_number": "626-626-5181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRIS",
"first_name": "KENNETH",
"middle_name": "RAY",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-05-15",
"last_updated": "2023-05-15",
"certification_date": "2023-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0101X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology",
"state": "NY",
"license": "322721",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Florence, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.